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Updated: Sep 29, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Knowledge about atrial fibrillation and anticoagulation affects the risk of clinical outcomes
Małgorzata Konieczyńska1, Piotr Bijak1, Krzysztof Piotr Malinowski2
1Department of Diagnostic Medicine, John Paul II Hospital, Kraków, Poland.
Insights
Patient knowledge about atrial fibrillation (AF) and oral anticoagulation (OAC) is insufficient. Lower patient knowledge scores correlate with higher rates of adverse events, including stroke and bleeding.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Atrial fibrillation (AF) patient knowledge regarding oral anticoagulation (OAC) is often inadequate.
- This knowledge gap may impact patient outcomes and adherence to OAC therapy.
Purpose of the Study:
- To investigate the association between AF patients' knowledge of AF and OAC and their risk of adverse events.
- To identify specific knowledge deficits that predict poor outcomes.
Main Methods:
- 174 anticoagulated AF patients (mean age 69 years, median CHA2DS2-VASc 4) were assessed using the Jessa AF Knowledge Questionnaire (JAKQ).
- The primary endpoint was a composite of ischemic cerebrovascular events, bleeding events, and death over a median follow-up of 42 months.
Main Results:
- The primary endpoint occurred in 27.5% of patients. Lower JAKQ scores were associated with the primary outcome, particularly bleeding events.
- Understanding the importance of regular OAC intake reduced cerebrovascular event risk (p<0.0001).
- Patients experiencing adverse events showed deficits in understanding AF, safe painkiller use with OAC, and managing forgotten doses.
Conclusions:
- Low knowledge about AF and OAC is a significant predictor of adverse events in anticoagulated AF patients.
- Improved patient education on AF and OAC is crucial for better management and outcomes.
Background:
Knowledge about atrial fibrillation (AF) and oral anticoagulation (OAC) is insufficient among AF patients.
Objective:
We examined the association between this knowledge and event rate.
Methods:
We studied 174 anticoagulated patients with AF aged 69±10.7 years (median CHA2DS2 -VASc 4). Knowledge was assessed at baseline using the Jessa AF Knowledge Questionnaire (JAKQ). The primary endpoint was a composite of ischemic cerebrovascular events, major or non-major clinically relevant bleeding, and death, recorded during a median follow-up of 42 months.
Results:
The primary endpoint occurred in 48 (27.5%) patients (10.5 per 100 patient-years) including 12 ischemic cerebrovascular events (2.2 per 100 patient-years) and 29 bleeding episodes (5.8 per 100 patient- years). Lower baseline JAKQ scores were associated with the primary outcome (p=0.007), solely when patients who bled during follow-up were compared with the remainder (p=0.007). Patients who were aware of the importance of a regular anticoagulant intake despite the absence of AF symptoms, had, however, a lower risk of cerebrovascular events (p<0.0001). The subjects who experienced bleeding or the primary endpoint were less likely to understand the essence of AF (p=0.03), to know safe painkillers used in combination with OAC (p<0.001), and what to do when the anticoagulant was forgotten (p=0.02). Worse knowledge about AF and OAC, longer OAC therapy, and higher CHA2DS2 -VASc score were independent predictors for the primary endpoint.
Conclusions:
Our study shows a prognostic value of low knowledge about AF and OAC supporting the need for improved education of AF patients.
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